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Organization
THERASPORTS PLUS PHYSICAL THERAPY
Active
Organization
THERASPORTS PLUS PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALTER PAUL VANCURA P.T. (OWNER/PHYSICAL THERAPIST)
(631) 543-2068
Entity
Organization
Contact information
Practice address
366 VETERANS MEMORIAL HWY, SUITE #2, COMMACK, NY 11725-4387
(631) 543-2068
(631) 543-2082
Mailing address
366 VETERANS MEMORIAL HWY, SUITE #2, COMMACK, NY 11725-4387
(631) 543-2068
(631) 543-2082
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
016205
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HIP
281045P
NY
01
—
QB3403
EMP BC BS
NY
Enumeration date
09/26/2006
Last updated
07/16/2008
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